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Research Report

This project's primary goal is to quantify export strengths and opportunities in Kentucky industries. We measure export strength as the relative dollar value of exports per worker in four digit industries using U.S. dollar value of exports per worker as the base. Tables were prepared for total exports and a selection of 50 countries representing 98.5% of Kentucky exports and 93.2% of U.S. exports. In addition to the export index, a measure of industry strength based upon labor and comparisons to regional competitor states is provided.

Industries with a low index value, either overall or for specific countries, present opportunities for exports as they reflect low exports relative to the rest of the country and controlling for industry strength and overall U.S. exports of that industry to that country.

Industries with a low industry strength index may be opportunities for Kentucky Economic Development Cabinet intervention. These smaller industries may lack resources necessary to establish trading agreements. Broad intervention on the part of the Cabinet may overcome this lack of resources and lead to higher exports and industry growth.

Some focus on the dollar value of exports per worker is warranted and these data are provided for the U.S. as a whole. These industries may present opportunities for high dollar value exports, which can lead to higher wages for workers.

Health navigation comes in many forms. Sometimes it takes the form of helping an individual find the treatment, medication, or health services they need. Other times navigation takes the form of helping a patient overcome barriers of child care, finances, or transportation so they can see a doctor. In other cases navigation means working with patients to enhance health literacy so they comply with medical instructions and are not readmitted to a hospital. And sometimes health navigation entails lending an empathetic hand to patients under‐ going the rigors of cancer treatment.

Here we adopt a fairly broad definition of what constitutes “health navigation.” We include individuals, groups, and agencies that most would agree are health navigators. At the same time, in the course of this research we came across many individuals who view themselves as health navigators—even if the purists do not. In general we err on the side of inclusion and encourage readers to make their own judgments. We also estimate the underlying demand for navigation services across Kentucky and conclude that the need for navigation is likely greater than the existing capacity.

This work is a collaborative effort between the Foundation for a Healthy Kentucky, the University of Kentucky College of Communication and Information, and the Center for Business and Economic Research (CBER) in the Gatton College of Business and Economics.

wo basic points come from our analysis of Kentucky’s tax system: a broader tax base is needed so that revenue can keep pace with future economic growth, and changes are needed to improve Kentucky’s economic competitiveness.

Without fundamental reforms Kentucky could face a $1 billion shortfall by 2020, and could find itself at a competitive disadvantage to neighboring states for business growth, retention, and recruitment.

The options we present below can improve future revenue growth and economic competitiveness—which are evaluated with respect to other important factors, such as fairness and simplicity. The Commission should view these options as alternative routes to a different tax system, but with varying implications for adequacy, elasticity, competitiveness, fairness, and simplicity.

Good policy is dependent upon good data. This is especially true in health policy. Here we provide data on the number of Kentucky Medicaid beneficiaries who have received a mental or behavioral health diagnosis from 2000 to 2010. A Profile of Kentucky Medicaid Mental Health Diagnoses, 2000‐2010 provides information on the total number of individuals who have been diagnosed with a mental health disorder as well as a year‐by‐year count of the 15 broad categories used to classify these diagnoses. Presented for children (age 18 and younger) and adults (19 and older), these data are organized at the state, regional, and county levels—which should enable leaders and citizens to compare mental health diagnoses between different communities. These comparisons should provoke important public policy and public health questions, such as what accounts for the different patterns across the state overall, between genders, and among races with respect to, for example, ADHD, developmental disorders, and substance‐related disorders. Moreover, used in conjunction with a companion report on Medicaid pharmaceutical utilization, the Kentucky Medicaid Pharmaceutical Utilization Guide, 2000‐2010, the strategic allocation of resources dedicated to improving health literacy can be advanced—among patients, health care providers, and the community at large.

This work is a collaborative effort between the Foundation for a Healthy Kentucky, the University of Kentucky College of Communication and Information, and the Center for Business and Economic Research (CBER) in the Gatton College of Business and Economics.

Understanding Medicaid pharmaceutical utilization in Kentucky is important: over $6.6 billion was expended in the state from 2000 to 2010 on outpatient medication; it has the potential to fundamentally transform the health and well‐being individuals, and by extension wider communities; and there is a continuing trend in the nonmedical use (and abuse) of prescription drugs, exacting a heavy toll on individuals, their families, and the wider community. The Kentucky Medicaid Pharmaceutical Utilization Guide, 2000‐2010 provides information on the 50 most utilized pharmaceuticals in Kentucky with respect to prescriptions, costs, and total grams—and presents this information for children (age 18 and younger) and adults (19 and older). These data are organized at the state, regional, and county levels—which should enable leaders and citizens to compare pharmaceutical utilization between different communities. These comparisons should provoke important public policy and public health questions, such as what accounts for the vastly different pharmaceutical utilization patterns across the state over‐ all, between genders, and among races with respect to, for example, pain medication, ADHD drugs, or antipsychotic medication. Moreover, this report can facilitate the strategic allocation of resources dedicated to improving health literacy—among patients, health care providers, and the community at large.

This work is a collaborative effort between the Foundation for a Healthy Kentucky, the University of Kentucky College of Communication and Information, the Center for Business and Economic Research (CBER) in the Gatton College of Business and Economics, and the College of Pharmacy’s Institute for Pharmaceutical Outcomes and Policy (IPOP).